Have a C-section? You still have to wait 6 weeks to have sex

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Raising a newborn means living on practically no sleep, while simultaneously keeping a tiny human alive. After giving birth, you probably aren’t ready to leave the hospital to jump straight in the sack, but you might wonder when you’ll be able to resume a normal sex life. If you’re expecting, or just curious about the process, here’s how the body heals postpartum.

Whether you give birth vaginally or have a cesarean section, you’ll need to give your body about six weeks to heal to protect the uterus. “A lot of the precautions that we give about avoiding sex, not swimming, or taking a tub bath, it’s because we’re worried about the risk of infection when the cervix is more dilated,” says Dr. Anna Reinert, a fellow in minimally-invasive gynecological surgery and chronic pain at Dignity Health in Phoenix.

“It’s easier for bacteria to climb up into the uterus if the cervix is dilated,” says Dr. Reinert. “Normally — when people are not pregnant, not postpartum, not having their menses — the cervix is very tightly contracted and so it would be hard to pass even like a thin straw up through it.”

What to expect after giving birth“For both the vaginal delivery and the c-section, your uterus is emptied of the pregnancy, so the placenta, amniotic fluid, and the baby come out,” says Dr. Reinert. The typical patient will experience bleeding that is heavier than a period, regardless of the delivery method, explained Dr. Reinert. The blood starts out bright red and will gradually lighten over the course of two to six weeks.

This vaginal discharge, called lochia, includes amniotic fluid, blood, bacteria, and immune cells. During the healing process, patients will shed small amounts of fluid daily, losing up to a half a liter total, according to Dr. Reinert.

Dr. Reinert explained that the cervix tends to be dilated a few centimeters for a few days after delivery. It will contract down to about one centimeter after about a week, for both vaginal deliveries and c-sections and remains dilated to allow blood and fluid to pass. The uterus also gets much smaller post baby. It contracts to detach the placenta, close off blood vessels, and shrink back to its normal size. This process, which reduces the uterus by about a fifth, can also lead to cramping.

Some things take longer to heal if you have a c-sectionDuring a c-section, the abdominal wall is cut open and the muscles are pulled apart to get to the uterus and the baby. Patients experience pain during recovery because the skin and muscles that were cut need to repair themselves, not because the uterus was lacerated, says Dr. Reinert. Most physiological changes of pregnancy reverse in about six weeks, but if you have a major abdominal surgery like a c-section, it might take more like eight weeks to heal, says Dr. Reinert. And patients may still have pain and decreased muscle strength even three months after the delivery, she says.

“Your body is still going to be healing the abdominal wall for a longer period of time.” says Dr. Reinert. “You want the uterus to heal well before getting pregnant again.”

When to call a doctorWhile everyone heals on their own timetable, your flow should lessen and the blood should become lighter over time. Around one to five percent of women experience a postpartum hemorrhage, so if you experience major bleeding — like having to change your sanitary pad every hour — or your discharge gets heavier after a period of getting lighter, call your doctor. “There still could be an infection risk without there being pain,” says Dr. Reinert. “The greatest risk from sex comes from having sex. The tissues aren’t quite as resilient to pathogens when they’re still healing.” Even if you aren’t experiencing pain and feel like your body is healed, make sure your provider gives you the green light before engaging in sex.

Keri Wiginton is a writer and photographer focusing on issues related to women's health, mental well-being, and feminism. Her work has appeared in the Chicago Tribune, Washington Post, Austin-American Statesman, Tampa Bay Times and Houston Chronicle. Follow her work at www.keriwiginton.com or on Twitter at @keriphoto.